NPI | 1871565325 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SD 1421) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SD 1421) |
Enumeration Date | 2006-02-07 |
Last Update Date | 2018-10-10 |